Provider Demographics
NPI:1174964522
Name:WALSH, WILLIAM FRANCIS (PHD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:FRANCIS
Last Name:WALSH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2738
Mailing Address - Country:US
Mailing Address - Phone:732-549-2384
Mailing Address - Fax:908-232-2988
Practice Address - Street 1:140 MAIN ST
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2738
Practice Address - Country:US
Practice Address - Phone:732-549-2384
Practice Address - Fax:908-232-2988
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00136600103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist